Implantation of Silmet Stents for Malignant Airway Stenosis

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Purpose :Metallic stents prove useful if the stenosis is inaccessible by rigid bronchoscope or if prior dilation or laser resection of stenosis is difficult However, disadvantages such as the removal of stents, replacement of stents, and the deterioration of long-term placements exist. Silmet stent (Novatech, France), a new metallic (nitinol) expandable stent with fully covered polyester membrane, has been developed. This study was undertaken to assess the Silmet stent for its efficacy and safety.Methods :Between March 2006 and October 2007, 16 Silmet stents were placed in 10 patients with inoperable central airway stenosis due to malignant tumors using flexible and/or rigid bronchoscope under fluoroscopy and endoscopy. Patient population consisted of 7 males and 3 females(mean age 65.9 years) and stenting was performed under intraveneous anesthesia in operating rooms.Results :After implantation of the stent, immediate relief of dyspnea was achieved in 7 patients. The dyspnea index evaluated by the MRC scale, showed significant improvements after stenting. (pre vs. post P<0.05). Also, FEV1 showed a marked improvement (P<0.05), and flow volume loops, although not remarkable, showed some improvements after stenting. No complications presented during stenting, however complications such as tumor overgrowth (1) and restenosis from granulations at both ends of the stent (1) occurred post-stenting. In 1 case, stent removal was possible after radio-chemotherapy.Conclusions :In this study, the placement of Silmet stents demonstrated dyspnea relief could be achieved in patients with minimal complications.